Sajeda A. ~ a breast cancer survivor shares her story from Hastings-on-Hudson, USA

I agreed to write about my experience with cancer for Adhunika’s blog because I wanted to do the right thing. Then I had serious second thoughts. I feel like mine is not a story to tell. It was not much of a ‘battle’. My experience has been nowhere near as painful or as heart-wrenching as that of others. It has not shaken me to my senses, to shed the 25 lbs that I need to lose for example.  I feel like these are the minimum elements that merit an entry into a blog about people “battling with cancer”. On the other hand, to the extent that it represents the more benign end of a wide spectrum of disease etiology, progression and prognosis, I guess it has a place. When I was first diagnosed with Ductal Carcinoma In Situ (DCIS) my doctor friend told me “if you must have cancer, this is the one to have”.  I do not intend to make light of my experience, and I certainly don’t want to do the same of the experience of others, but here goes.

In a nutshell, my cancer has been pretty painless so far. I was diagnosed after a routine mammogram in August 2010 detected suspicious calcification, later confirmed to be malignant through needle biopsy. A diagnosis of DCIS is given when a biopsy shows the presence of malignant cells but the cells are contained within the ducts and have not escaped. As I understand it, the vast majority of breast cancers originate in the duct. Cancers are also classified into stages (0 to 4) of progression and sometimes grade based on the pathology reports– in my case none of my doctors seemed to pay much attention to the grade and mine was stage 0.  I was recommended the standard treatment for early stage breast cancer—surgery to remove the offending breast tissue followed by six weeks of radiation treatment five days a week. I have chosen to go on Tamoxifen following surgery and radiation. This is a preventive drug that interferes with the production of estrogen, a hormone that promotes cancerous growth of breast tissue, and is usually recommended for more advanced cancer. I debated ad infinitum about this decision, with myself and with my radiologist and my surgeon. I am still not sure it was the right decision. I have been on it for about six months and have experienced known side effects such as regular hot flashes.

I had to have two surgical procedures, both as day surgery. Once the surgeon removes the cancerous growth, a portion of the tissue on the margins of the cancerous area is sent for testing.  The surgeon did not get clear margins the first time around so she did another similar procedure about three weeks later. Perhaps the most painful part of the whole thing is needle localization done while your breast is in compression in a mammogram machine. It is done by a radiologist just prior to surgery (and without the benefit of anesthesia) to insert wires and pins to mark the area of malignancy. Although the surgery was done under partial anesthesia with sedation, I was completely out for the two hours or so of the procedure. They prescribed narcotic pain-killers (Vicodin) but I did not need to take more than one or two.  My radiation treatment began in January and ran through many snowstorms to the middle of March. The hospital is about a mile away from where I work and I scheduled treatments during the middle of the day. I was usually gone from work for a little over an hour each day.  Many people complain of exhaustion and some skin discomfort—the point of radiation is that they are trying to burn any cancer tissue that may have escaped the surgery. In the process there may be some second degree burns to the skin.

Of course, this whole process is something of an emotional roller coaster. I struggled about how to tell my daughters, then ages 11 and 4. I tried to keep it from my mother until I had a good handle on it myself. She found out anyway by reading my unguarded emails to my sister and was amazingly stoic. I admit I had a few meltdowns, though, thankfully, not in front of my children. I sought the help of a social worker from Memorial Sloan Kettering who gave me an hour of very useful advice on the phone one morning. After that I was able to talk to my daughters truthfully and optimistically, without inducing trauma or much drama. Children are very resilient and my daughters seemed to ride out the experience reasonably well. I found that it was oddly reassuring for them to hear about my various procedures in excruciating detail. I chose not to bring them to the hospital because that can be overwhelming. At an early phase of my diagnosis, I decided to inform a rather wide circle of friends and colleagues anticipating that I may be out of commission for some time. In hindsight I am slightly embarrassed and believe I need not have reached out quite so wide. Of course, at the time I expected to be put out much more by the surgery and the treatment than ended up being the case.

I have been blessed by a very supportive circle of family and friends. My sister traveled from Bangladesh twice to be with me during the surgeries and radiation. By brother, sister-in-law, cousins and friends kept up a constant stream of phone calls and visits. My children and my household could not have done without our very dependable care-giver. I received excellent care at Memorial Sloan Kettering Cancer Center and have been very fortunate that we have good health care coverage.

In retrospect I would say that the time of receiving the first diagnosis was perhaps the most harrowing. I had a week or so when I was both emotionally distraught and not getting much medical guidance on who to go to and what to do. The radiologist who gave me the initial diagnosis suddenly got really busy and could not schedule me for a needle biopsy that he himself recommended. My decision at that time to switch hospitals and go to Sloan Kettering was the best decision I made. It turns out I could not have chosen a better team.

I have several friends who have been through diagnosis and treatment of cancer. Each of us has dealt with it very differently. Some have radically changed their diets. Others have gone on intensive physical regimens. One friend started a group called “kick cancer’s butt”. Another formed a group of survivors who call themselves “can-can girls”.  Yet others have sought spiritual recourse and yoga. Each of us has to find our own path. My own comfort level has been to say that I would not make radical changes and that I will not let cancer run my life. I will admit I have gone organic. Now to go and lose that weight!

Sajeda A.

October 5, 2011